Let’s bank the win rather than let Big Pharma bankroll a win for themselves.
Heading into this year’s midterms, Republicans are jittery. There is particular concern that Democrats could hold over our collective heads the failure to extend pandemic-era Obamacare subsidies, blaming the GOP for healthcare “affordability” problems.
But set aside that Democrats have done precious little to rein in wasteful spending by big hospitals on things like hotel and pizza parlor acquisitions, and even ventures in Antarctica—which we all have to foot the bill for via our insurance premiums and taxes. The GOP also has a secret weapon: President Trump’s Most Favored Nation (MFN) policy in exactly its current form.
Last May, Trump issued an MFN, a market-wide solution demanding drug companies offer price parity for medicines sold abroad. It has long been known that drugmakers charge Medicaid as much as 422 percent more for certain pharmaceuticals than they do in other countries. But responding to the president’s Rooseveltian big stick, many of the Bigs have agreed and dropped their prices on brand-name drugs.
The Chicken Littles have been proven wrong about the effects, too. As Axios recently reported, “the voluntary White House deals [are] tolerable for the industry,” and “the agreements were mutually beneficial for both parties.”
So we’re winning – but let’s make sure we don’t start losing.
The MFN policy currently exists thanks to an Executive Order. That’s great, not just because it’s working, but because it tethers a drop in drug prices to Trump, personally. While there is a desire for Congress to codify it into law, that creates two big problems for the GOP. One is political. One is substantive.
Keeping MFN as a Trump Executive Order, and only an Executive Order, reinforces his reputation as a deal-maker who can uniquely deliver for Americans. It keeps him firmly in the driving seat as he goes out on the campaign trail to sell Americans on the discounts he has obtained. It deprives congressional Democrats of the ability to take credit for Trump’s result or to look like reasonable, bipartisan people interested in collaborating with the president. And as Democratic responses to Trump at the State of the Union demonstrate, they are clearly, well, crazy—not reasonable or bipartisan. American voters should know it and feel it heading into November.
Codification will also be a nightmare to navigate, and would probably result in Democrats torpedoing Trump’s already-banked win. As anti-Trump Republican Sen. Bill Cassidy warned earlier this year, “there’s a lot of details to work out if you even think it’s a good idea,” and remember, Cassidy and actual socialist Bernie Sanders run the committee that would be responsible for writing and advancing the law. Does anyone really think a deal cut with those two won’t scupper all of Trump’s MFN gains? Especially since a diminishing House GOP majority might mean the need to rely on Democratic votes to get a bill passed?
A big worry about MFN—even from several pro-Trump think tanks, behind the scenes—is that, if done wrong, it might end up hurting smaller drugmakers responsible for most of the medical innovation we see, and helping the Bigs. One of the concerns is that it will be easier for big pharmaceutical companies to adapt to codified MFN policies than for smaller ones, especially if any Democrats are involved in writing a codification bill. And if Congress passes a law, no tweaks will be able to be made as we go along to address any issues like this.
Moreover, should Congress get its hands on a big, non-beautiful bill like this, all the members working for Big Pharma will probably write it in a way that’s better for them and worse for their smaller competitors. We could also see “anti-Big Pharma MFN” turn into a stealth maneuver by one Big to get one over on another Big. Remember, this is what Sen. Amy Klobuchar was called out for doing when she pushed a supposedly “anti-Big Tech” bill that just so happened to benefit her home state mega-corporation Target while hammering its chief competitor, Amazon.
Like Jafar tells Aladdin: “Whoever has the gold makes the rules.”
Subjecting MFN to the legislative process opens the door to contaminating the policy. We want drugmakers to charge reasonable rates to patients and Uncle Sam, but we don’t want an MFN policy that might inadvertently make Big Pharma bigger—or help figures like Sen. Jon Ossoff or Texas’s multiple vulnerable Democrats in “tossup” and “red” seats to share credit with Trump and ride his name and goodwill all the way to reelection.
Deregulation works. Deals work. The president has won here – so he can run on that for the contentious midterms. Trump should bank the win and get busy doing what he does best: Selling results on the campaign trail.